H. Grasemann et al., THE TREATMENT OF LEGG-CALVE-PERTHES DISEASE - TO CONTAIN OR NOT TO CONTAIN, Archives of orthopaedic and trauma surgery, 116(1-2), 1997, pp. 50-54
In order to evaluate a treatment protocol involving a non-containment
method and femoral osteotomy when lateral subluxation of the femoral h
ead develops, 39 children with 42 affected hips were examined radiolog
ically an average of 7 years (4-16 10/12) following the onset of Legg-
Calve-Perthes disease. Twenty-six hips were treated conservatively wit
h an ischial-bearing, Thomas-type splint and 16 with a femoral varus d
erotating osteotomy. Both Catterall and Herring gradings were used. Th
e end result was evaluated according to the Stulberg classification. A
ll Catterall grade I (n = 8) hips had a satisfactory result regardless
of age at onset and method of treatment. In Catterall groups II-IV (n
= 34), age at onset influenced the treatment outcome. In children aff
ected before the age of 8 years, results of conservative treatment wer
e originally satisfactory but were seen to deteriorate with advancing
age. In children over 8 years old (n = 13), the results clearly favour
operative containment.